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Arkansas rates for HCPCS 42200

Palatoplasty for cleft palate, soft and/or hard palate only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,819.70 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $977.24 / $1,479.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $1,348.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $7,413.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $977.24 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $794.33 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,148.15 / $1,659.59
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $2,951.21 / $9,332.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,071.52 / $1,659.59